Individual
LISA L GILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 662-6755
(801) 662-6756
Mailing address
100 MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 662-6755
(801) 662-6756
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
35.084267
OH
2084P0800X
Psychiatry Physician
6802678-1205
UT
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
6802678-1205
UT
Other
Enumeration date
05/18/2007
Last updated
11/01/2021
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